Neurosurgery at the Fujita Health University (FHU) began in 1972 by Dr.Tetsuo Kanno (Fig.1).1 The FHU is located about 10 km southeast of Nagoya City, Japan. The neurosurgical residency program was established by Dr. Tetsuo Kanno in 1978.
Dr. Yoko Kato who has been trained at the FHU joined the neurosurgery department at the FHU in 1985 as senior faculty. Dr. Kato was a part of the vascular team.
The Asian Congress of Neurological Surgeons (ACNS) originated from the organization of the first “Seminar for Young Asian Neurosurgeons” conducted in 1993 by Prof. Tetsuo Kanno (Fig. 2).
Prof. Tetsuo Kanno started the neurosurgery fellowship for foreign neurosurgeons in 1994. Besides that, he also donated equipment such as surgical microscopes and surgical instruments performed in the respective developing countries.
The Initial fellowship program has been conducted at the Fujita Health University (FHU) is located in Toyoake City (Fig.3).2 It is 30 km from Nagoya Airport and 30 km also from the center of Nagoya City.
The FHU as the WFNS Training Centre has been relocated to the Fujita Health University Banbuntane Hotokukai Hospital Post-Graduate Training Center in 2014 (Fig. 4).3
Prof. Yoko Kato who is currently the Head of Department of Neurosurgery and the Deputy Director of the FHU Bantane Hospital has been accepting many foreign young neurosurgeons from all over the world for their fellowship program since 2014 (Fig. 5).
Fig. 1: Late Prof. Tetsuo Kanno, founding father of the Asian Congress of Neurosurgery
Fig. 2: The first “Seminar for Young Asian Neurosurgeons”
conducted in 1993 by Prof. Tetsuo Kanno
Fig 3: Fujita Health University (FHU) is located in Toyoake City
Fig 4: Fujita Health University Banbuntane Hotokukai Hospital
Post-Graduate Training Center
Fig. 5: Photograph of Prof. Yoko Kato, the Head of Department of Neurosurgery and the Deputy Director of the FHU Bantane Hospital
About the Training Center
Banbuntane Hotokukai Hospital is the second teaching hospital where located in the downtown of Nagoya, Aichi. It is an excellent center of stroke and advanced neurosurgery center. The hospital is belonging to the Fujita Health University Hospital that has more than 1,500 beds, which is the greatest number in a single medical institution in Japan. Approximately 2,100 patients visit our outpatient department every day, and we perform more than 11,000 surgeries a year.
Neurosurgery Fellowship Program at the Department of Neurosurgery, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
The name of the course is “Advance training in Neurosurgery, Fujita Health University Banbuntane Hotokukai Hospital”. The purpose of the establishment of the program is to enable neurosurgeons from abroad or Japan to be trained in the advanced technique of neurosurgery. The Director course is Professor Yoko Kato, who is the Head of the Department of neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan.
The duration of fellowship can be either 1 month, 3 months, 6 months, or 1 year. Fellows will be allowed attend to conferences, workshops, and other educational activities in Japan and international conferences during the fellowship period. At the end of the training, fellows will receive the certification from the institute.
The subspecialties training available include:4
The daily activities during the fellowship are as follows:
The timetable of the daily activities is shown below (Table I):
Table I: Timetable of daily activities
Fellows will be paid the accommodation charges during studying in the department. The department will arrange the apartment where located near the hospital, the total cost is 60,000 JPY approximately/ month. (included the electricity and water). The accommodation place is located near the teaching hospital. Traveling expenses should be borne by the fellows.
The YOKO KATO International Foundation supports follows:
The convenience store and supermarket are nearby the hospitals. The train station and Nagoya city are very convenient to get there. The application can be sent to the email to: firstname.lastname@example.org with a recommendation letter, curriculum vitae, and resume to the following address: 3-6-10 Otobashi Nakagawa-Ku, Nagoya, Aichi, Japan 4540012.
Tel+ 81 52-323-5970; Fax + 81 52-323-5800.
History of the Neurosurgery fellowship program at the Fujita Health University
A total of 36 foreign students had undergone training at FHU under Prof. Tetsuo Kanno, Prof. Hirotoshi Sano (Fig.6), and Prof. Yoko Kato when the program was first established in 1994, till 2000. During that period, all foreign young neurosurgeons were originated from Asia countries except one from Egypt and one from Oman (Fig.7).
Fig 6: Prof. Hirotoshi Sano
Fig.7: Geographic heat map showing the origin of the neurosurgical fellows
at the FHU between 1994 till 2000.
The training center moved to the FHU Bantane Hospital in the year 2014 with Prof. Yoko Kato as the Program Director. Since then 91 foreign young neurosurgeons have joined the program. The fellowship program has been temporarily suspended in mid-2020 due to the COVID-19 pandemic when international traveling was not been permitted. The number of students according to the country of origin with some fellows from outside Asia is shown in the figure below (Fig. 8). The number of foreign students have increased dramatically from 2014 till 2020. However, it was reduced in 2020 due to the pandemic (Fig. 9).
Fig.8: Geographic heat map showing of the origin of the neurosurgical
fellows at the FHU between 1994 till 2020.
*Data between 200 and 2014 are not included
Fig. 9: Bar graphs showing the number of the neurosurgical fellows at the
FHU between 1994 till 2020 according to the period of fellowship (year).
The duration of fellowships was varied among the fellows with the majority of the fellows spending 3 months at the FHU (Fig. 10).
*Data between 200 and 2014 are not included
Fig. 10: Bar graphs showing the number of the neurosurgical fellows at the FHU between
1994 till 2020 according to the duration of the fellowship (month).
The table below is the name and the country of origin of fellows between 2014 till 2020 at the FHU Bantane Hospital, Nagoya, Japan (Table II).
Table II: Name of the fellows with their country of origin according to the year of the fellowship
Abu Saleh M.A. Obaida
Prasana K L
Mohd. Ahmed Ansari
Shamim UlHaq Siddiqi
Mayur Kamath V.
Hanh Van Duc
Liew Boon Seng
Mohammad Abdul Ameen
Ahmed Mohmmed Asiri
Raja Krishnan Kutty
Raghavendra Kumar Sharma
Ram Kumar Goyal
Syah Ahmed MedjdoubAbderrahmane
A video on the student’s experience shared by Dr.Dhivya Palanisamy, who did her Neurosurgery fellowship at the Fujita Health University Bantane Hospital, Nagoya from 15th March till 13th May 2018 can be found online.5 Another fellow, Dr. Ashish Kumar, who did his fellowship at the Fujita Health University shared his experience in a publication entitled “Advances in neurosurgery: The Fujita Health University experience” in 2011.6
Below are the excerptions of some reports written by the fellows on the International Fellowship at Fujita Health University in Neurosurgery for Young Neurosurgeons.
Name: Vladimir Balik, M.D.
Subject: International Fellowship for Young Neurosurgeons at Fujita Health University
Host Institution: Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan
Host Supervisor: Yoko Kato, prof., M.D., Ph.D.
Dates of Fellowship: 30th September 2015 to 20th December 2015
Fujita Health University (FHU) is a worldwide recognized center of excellence in neurovascular surgery. The neurovascular team of the FHU Banbuntane Hotokukai Hospital in Nagoya consists of Kato, Tsukasa Kawase, Yasuhiro Yamada, Yamashiro Kei, Daisuke Suyama. Prof. Yoko Kato, the head of the department, is well recognized and has earned the respect across the world. Many international fellows visit the department for gaining expertise in the surgical management of cerebral aneurysms, arteriovenous malformations, trigeminal neuralgia, facial spasm, and vascular bypass procedures.
I joined the morning clinical meetings, journal clubs, ward and neurosurgical care unit rounds, and participation in educational discussions (Fig. 11). Overall, I participated in more than 45 surgeries performed by Prof. Kato. After each operation, and during it Prof. Kato discussed with us details of the procedure, tips and tricks, potential complications, and their avoidance.
I also attended numerous vascular and oncology conferences such as the 74th Annual Meeting of the Japan Neurosurgical Society during 14-16, October 2015 in Sapporo, and presented a poster presentation of the patent fibrous tract in an adolescent with disconnected lumboperitoneal shunt. I could also listen to lectures and discussions of many famous neurosurgeons such as Takeshi Kawase, Hirotoshi Sano, Robert Spetzler, Christopher Loftus, Peter Vajkoczy, Atul Goel, and others. Sapporo is a city with a mixture of the atmosphere of metropolitan, beautiful scenery, good food, and friendly people. All this offered me a unique opportunity to meet new interesting people (Fig. 12).
Fig.11: After ward and neurosurgical care unit morning rounds (from left Vladimir Balik, Sandeep Talari, Rile Wu, Yoko Kato, Yasuhiro Yamada, Tsukasa Kawase)
Fig.12: Nice evening with nice people and food. All this you can experience in Sapporo (from left Vladimir Balik, Sandeep Talari, Yasuhiro Yamada, MojganHodaie, Hidehito Kimura, Marcus A.Stoodley, Yamashiro Kei)
I have also written three manuscripts during the period of the fellowship. The first manuscript was, entitled “Surgical treatment of unruptured dissecting intracranial aneurysms of vertebral – posterior inferior cerebellar artery region”. The second and third papers reviewed on current knowledge on the incidence, pathogenesis, clinical presentation, diagnostic procedures with special emphasis on surgical treatment of intracranial dissecting aneurysms in the anterior and posterior circulation, respectively.
I have also attended neurosurgeons from other neurosurgical centers such as Dr. Tadashi Watanabe from Japanese Red Cross Nagoya Daini Hospital in endoscopic transnasal procedures (Fig. 13). I have also met Prof. Hirotoshi Sano, also known as “White Jack”. Prof. Sano was always present technically challenging cases and he constantly shared his experience in aneurysmal clipping surgeries with fellows (Fig. 14). And finally, Dr. Katsumi Takizawa from Asahikawa Red Cross Hospital, who has vast experience with bypass procedures and is an internationally renowned neurovascular surgeon, demonstrated his skills in STA-MCA bypass procedure and paraclinoid aneurysm surgery (Fig. 15).
Fig.13: Late evening in the Japanese Red Cross Nagoya Daini Hospital after perfect transnasal endoscopic tuberculum sellae meningioma removal (from left Tetsuya Nagatani, Vladimir Balik, Sandeep Talari, Tadashi Watanabe)
Fig.14: Nice discussion in operating theatre with two famous Japanese neurosurgeons (from left Yoko Kato, Hirotoshi Sano also known as “White Jack”) and friendly, open-minded anaesthesiologist lady (Noriko Yuzawa with me) shortly after the perfect clipping done by Prof. Kato
Fig.15: Master of bypass surgery explained his tips and tricks during the STA-MCA bypass procedure (from left Vladimir Balik, Yoko Kato, Katsumi Takizawa, two medical students and Sandeep Talari)
The fellowship has given me more than I actually expected. It provided advanced neurovascular training and the expansion of opportunities for cooperation. Since the international fellowship at FHU itself reliance on the capabilities of the selected fellows, finally really provides room for original thoughts and work. I think this fellowship program is a fantastic one and offers unique training and research opportunities to young.
Name: Dilshod Mamadaliyev
Republican Specialized Scientific and Practical
Center of Neurosurgery. Tashkent, Uzbekistan.
Cell.no.: +99893 108 08 02
As a clinical fellow, I had an opportunity of visiting Bantane Hospital, Fujita Health University in 2016 provided by WFNS and prof. Yoko Kato’s support. Without any doubt, I can say that the fellowship program in Banbuntane Hotokukai Hospital under the supervision of Professor Yoko Kato is one of the best fellowships that I have experienced ever. This training has provided me with more than I actually had expected. It is the best program for those who are going to be specialists in the field of cerebrovascular neurosurgery and not only vascular but also for other subspecialties. Prof. Yoko Kato, the head of the department, is well known and respected neurosurgeon of the world arena. Many international fellows visit the department for gaining expertise in the surgical management of cerebral aneurysms, arteriovenous malformations, trigeminal neuralgia, hemifacial spasm, and vascular bypass procedures.
After finishing my training in Nagoya, I could understand the basic points, pearls of neurovascular surgery. I had a great experience in Japan. During the fellowship program, I have witnessed a number of high-quality, beautiful vascular surgeries by prof Kato, Dr. Takizawa in Bantane, skull base surgeries in Hamamatsu by Dr. Sameshima, unique endoscopic surgeries by Dr. Watanabe in Red Cross Hospital. I could see and assist in many surgeries. I learned many new pearls from positioning to the closure of wounds. I could see and assist in many bloodless surgeries. Most of the modalities of investigations- fusion images, Indocyanine green angiography, were new to me. I could see and assist many other surgeries like cerebral aneurysms, bypass, AVMs, endoscopy for ICH and sellar tumors, skull base tumors, etc. Also, we have experienced a one-day cadaveric workshop in a Hamamatsu city, supervised by Dr. Tetsuro Sameshima, who helped us to understand surgical anatomy better. We had a preoperative discussion in the mornings which was useful for knowing the clinical details and points about approaches, reasons, etc. Prof. Kato used to ask questions at the conferences and during operations and give us various learning assignments. I also learned about ICG and Flow800, CFD analysis which we don’t use in our hospital as our microscopes don’t have that support. I learned a lot from my Japanese philosophy of treating patients, I’ve learned from my Japanese mentor’s humbleness, modesty, and friendliness among colleagues and many other qualities that need every human being. These qualities play a crucial role in better patient care. I have great respect for Japanese people at all.
Although staying away from my country and my family was difficult, I felt we have many similarities with Japanese people in manners. We have earned many friends and colleagues via collaboration in neurosurgery holding several numbers of international congresses and conferences both in Uzbekistan and in Japan. I wish to keep in touch with my Japanese friends and mentors as frequently as possible and wish professor Kato and her team the best of luck and the best of success.
Fig. 16: Left to right: Me, Dr. Katsumi Takizawa, Dr. Sandeep Talari, Dr. Tushit Mewada and Professor Yoko Kato.
Fig.17: 25th annual Conference on Neurosurgical Tools and Techniques in Niigata
Fig.18: Live surgery during 2nd Winter Seminar in Bantane Hospital.
Fig.19: Second Winter Seminar on Cerebrovascular Diseases 2016 in Bantane Hospital. A Family of Neurosurgeons.
Fig.20: 21st Annual Meeting of the Japan Society of Neurosurgical Emergency in Tokyo.
Fig.21: Assisting Dr.Tetsuro Sameshima in performing a surgery.
Kanno T, Kato Y, Sano H, Shoda M, Nonomura K, Imai F, Kawase T, Kanaoka N, Bannur U. Neurosurgery at Fujita Health University, Japan. Minim Invasive Neurosurg. 2000 Jun;43(2):106-8. doi: 10.1055/s-2000-8328.
2. Fujita Health University. Support to the young Asian brain surgeon. (Cited Nov. 2021) Available at: http://www.fujita-hu.ac.jp/~neuron/en/backup_asia/index.html
3. WFNS. Criteria of Fujita Health University, Post-Graduate Training Center. (Cited Nov. 2021) Available at: https://www.wfns.org/print/training-centers/11/
4. Fujita Health University Bantane Hospital, Department of Neurosurgery. Clinical Fellowship Program. (Cited Nov. 2021) Available at: http://neuron.bantane-hospital.info/article/clinical-fellowship-program
5. Alumni Association Online Neurosurgical Symposium, November, 2018. (Cited Nov. 2021) Available at: https://www.youtube.com/watch?v=VknJP_cQhiA
Kumar A. Advances in neurosurgery: The Fujita Health University experience. Asian J Neurosurg. 2011 Jan;6(1):32-8. doi: 10.4103/1793-5482.85633. PMID: 22059102; PMCID: PMC3205549.